Healthcare Provider Details
I. General information
NPI: 1801208087
Provider Name (Legal Business Name): MERCY HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2014
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
905 E COLBY ST
WHITEHALL MI
49461-1262
US
IV. Provider business mailing address
PO BOX 932988
CLEVELAND OH
44193-0029
US
V. Phone/Fax
- Phone: 231-672-8050
- Fax: 231-728-5918
- Phone: 800-494-5797
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
GREEN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 616-685-6709